Duodenal atresia is a congenital disorder in which the top section of the small intestine is completely blocked because of a physical deformity. Food cannot move from the stomach into the intestines, and a newborn with the disorder is likely to vomit frequently. Duodenal atresia is usually fatal if treatment is not administered within the first couple days of life. A team of skilled surgeons can attempt to correct the condition by manually opening the intestine and removing tissue that is causing the blockage. With effective surgery and frequent follow-up examinations, most infants are able to begin developing normally.
The duodenum is the uppermost portion of the small intestine, connecting the stomach to the main intestinal tract. It is essentially a hollow tube that aids in digestion. In the case of duodenal atresia, the tube is closed or blocked off by an abnormal mucous membrane. As a result, an infant's body is unable to properly digest food, absorb nutrients, and process waste. A similar condition called duodenal stenosis occurs when the tube is narrowed but not fully closed off.
Doctors are largely uncertain of the exact causes of duodenal atresia. Most babies who have the condition are born prematurely, and their digestive tracts never fully developed during gestation. The presence of other structural deformities and Down's syndrome are common in infants with duodenal atresia.
The most common symptoms of duodenal atresia include vomiting and swelling in the abdomen. Vomit typically contains large amounts of bile, giving it a green hue. Since babies do not process waste, they are unable to urinate or pass stools. Symptoms of Down's syndrome may also be present, such as an oddly-shaped skull or a lack of muscle tone.
In many cases, duodenal atresia is diagnosed prenatally via routine ultrasounds. An obstetrician might notice an abundance of amniotic fluid in the womb, an indication that the fetus is not properly digesting and processing it. After an infant is born, ultrasounds and abdominal x-rays can reveal the actual deformity causing the blockage. Doctors may decide to perform additional diagnostic tests to check for other abnormalities and Down's syndrome.
Surgery is almost always the only option available to correct duodenal atresia. A surgeon makes a small incision near the navel and inserts a specialized camera to identify the location and nature of the blockage. Surgical tools are used to open the duodenum and suture it to the intestine. During surgery, the infant is usually given a feeding tube and intravenous fluids to prevent dehydration. Follow-up examinations are important to ensure the procedure was successful and that the baby is digesting nutrients.